2006 OPEN FORUM Abstracts
RISK OF BACTERIAL CONTAMINATION OF SHARED USE METERED DOSE INHALERS: PROSPECTIVE SURVEILLANCE FROM ONCOLOGICAL ICU
Malik, I. MD, Finch, C. RRT, Rudersdorf,
T., Price, K. MD
University of Texas MD Anderson Cancer Center, Houston, TX
Background: Continuous use of metered dose inhalers (MDI)
between patients is a common practice in hospitals and is presumed to have a
low infection risk. Since the MDI canisters are not sterile, contamination is
likely despite conscientious decontamination of surfaces and aseptic
techniques. Bacterial contamination of shared MDI canisters may pose special
risks for cancer patients who are vulnerable to infection due to leukopenia and/or immunosuppression.
More aggressive and multidrug resistant organisms are
frequent in cancer patients who are on multiple antibiotics. We studied the
rate and seasonal variation of bacterial contamination from shared-use of MDI
canisters in the medical and surgical oncological ICU
of a large comprehensive cancer center.
Methods:
Microbiological data from specimens obtained from shared-use MDI's were collected prospectively over a period of 3
months. All adult and pediatric
non-ventilated ICU patients who required bronchodilators via MDI were enrolled
in the study. Sterile specimens were
taken from 3 different sites on the MDI.
The inner aspect of right and left lip of the canister at the junction
between the canister and spacer, and the MDI plastic sleeve were swabbed using
Cult swab+Amies gel swab (Cardinal Health Medical
Products, OH) and BD BBL Culture SwabT Plus (Beckton
Dickson, MD). The specimen were transported immediately and set up on blood
agar, chocolate agar and MacConkey agar medium, and
incubated for 72 hours.
Result: Each canister
served approximately 20 patients.
Analysis of microbiological swabs from the 50 MDI canisters showed no
growth of bacteria at 72 hours of bacterial cultures. The MDI's were not
contaminated or infected with bacteria due to shared-use among critically ill
cancer patients.
Conclusion: Our results suggest that shared-use MDI
canisters are relatively safe to use in critically ill cancer patients with no
risk for infection or cross contamination between patients.